Reflecting the Change You Want to See – The Importance of Involvement in Equity and Inclusion Initiatives

From the January 27, 2023 issue of the Transformational Times

Perspective/Opinion

Reflecting the Change You Want to See – The Importance of Involvement in Equity and Inclusion Initiatives

By Michael Stout, Ed.D. – Master of Science in Anesthesia Program Director

The importance of diversity and equity in our organization is demonstrated by our values. But how we invest our time is where real change is cultivated… 

Diversity, Equity, and Inclusion goals are often easier to design than they are to achieve. We value their importance, yet gaps persist. These issues were seldom mentioned when I first entered graduate school. More recently, I would be hard-pressed to find a college leader who does not support DEI initiatives. It appears we renewed interest and enthusiasm for addressing gaps and inequality wherever they exist, including our college campuses. Creating a thriving community built on principles of respect and inclusion remains an institutional priority, but how can we make it imperative? The benefits of participation in DEI initiatives can extend beyond individual growth and development and promote positive change beyond our role. 

Admittedly, I have struggled to find time to participate in development programs. There are countless instances when I have received an email and thought, “That sounds interesting. I would really like to attend that event” only to be pulled immediately back into the consuming list of my daily tasks. Inevitably, the date passes without consequence. While missing an opportunity is usually disappointing, the explanation that other activities were more pressing suffices to allay my concern. However, the impact my non-participation has on my team, and the larger organization, is often missed. A person’s priorities can be discerned by where they spend their most precious resource, their time. How could my faculty, staff, and students understand my support of DEI initiatives, if they do not see me participate? 

These programs are designed to help move our organization

The resources dedicated to them aim to transform our campus community and achieve outcomes that align with our values. As an academic leader, I wish for everyone in my unit to attend these events. I welcome the transformational ideas they bring back to our team. But if I choose not to participate, why would I expect that anyone else will? Therefore, my decisions have expanding ripple effects. These decisions not only impact my own development, but can also impact my team, and the larger organizational culture. 

There is growing evidence that improving diversity yields benefits in both private and public institutions. To this end, I pledge to attend an IWILL event to broaden my views on gender. These programs present opportunities to demonstrate our commitment to improving organizational culture. I am grateful for all the hard work, generously provided, by those who organize and attend them. 

While the demands upon our time are likely to remain unchanged, investing in these initiatives can help close the gap between the aspiration for change and its achievement. 

Michael Stout, EdD, is an Assistant Professor in the Department of Anesthesiology at MCW, a Certified Anesthesiologist Assistant, and Program Director for the Master of Science in Anesthesia Program at MCW.

Bearing Witness to Pain

 From the January 27, 2023 issue of the Transformational Times

MedMoth Story

 

Bearing Witness to Pain 

 

 

By Meghan Schilthuis 

 

 

Meghan Schilthuis, a third-year medical student at MCW-Milwaukee, shares an impactful patient encounter from her first clinical rotation. This story was shared as part of the 2022 MCW MedMoth storytelling evening…  

 

I began my M3 year this past June on my pediatrics rotation, excited to convert knowledge gained from many hours spent studying for the USMLE Step 1 into “the real world” of patient care. I spent my first two weeks in outpatient clinics and had a lot of fun interacting with relatively healthy kids. I wasn’t sure what to expect as I moved to the inpatient portion of the rotation and began a week of night float at the Children’s Hospital of Wisconsin.  

 On my second or third night, my intern and I got a call about an adolescent boy who would be coming up to our team. I began looking through his chart and learned that this boy, who I’ll call Zack, was being admitted with concern for infection in the context of extensive burns suffered a few months prior. My heart fell when I read that these burns were the result of an attempt to end his own life. What sort of situation would we be walking in to?  

When Zack arrived on the floor, my resident and I went to go see him together. We found him lying in bed, heavily bandaged, and clearly in a lot of pain. After we gathered some history and did as much of a physical assessment as possible, Zack’s mom looked at my resident and asked, “Could we speak out in the hall for a couple of minutes?” I wasn’t sure if I was supposed to follow my resident out into the hall, but felt like I should stay behind with Zack. 

 As my resident and Zack’s mom walked out, I had a brief moment of panic; what could I do or say that could possibly help him feel any better? I had no medication to offer him. His skin was so painful to the touch that I couldn’t offer a hand of comfort. I settled for asking him about the stuffed frog he had. He suddenly stopped writhing, locked eyes with me, and exclaimed, “I wouldn’t have done it if I knew it would be this much pain!” Even though we hadn’t talked about how he got his burns, we both knew exactly what “it” he was referring to.  

I fought back any chance for my eyes to well up with tears. “I’m sorry you’re in so much pain. We’re going to do everything we can to help you feel better.” Even though I knew I probably shouldn’t, I couldn’t help but think of my little brother who is the same age as Zack; my little brother who loves to play football and baseball, concoct interesting culinary combinations, and learn new songs on his bass guitar. How could a middle schooler like Zack be saddled with so much pain at such a young age? 

After a few minutes, Zack’s mom came back with my resident and said to me, “I’m sorry, Zack can be a little dramatic.”

“Oh, no, don’t worry,” I told her as I waved goodbye. My resident and I left to staff the case with the attending before our next admission. 

The busyness of the rest of the shift kept me occupied, but I found myself thinking about Zack as I drove home and got ready for bed. When I called my mom to catch up the next day, I shared some of the story with her. She could tell that I was still feeling badly about Zack. She encouraged me to stop worrying about him, which sounded a little harsh to me at first, but she was correct in pointing out that my concern would not change things for Zack. 

Even still, I left our conversation wondering how physicians can best bear witness to their patients’ suffering without allowing it to consume their thoughts. 

In my interaction with Zack, I felt a tension between my strong desire to alleviate his pain and an uncertainty about how to do that. Even though I felt like there was little I could do for him at the time, looking back, I hope that our brief connection helped him feel less alone in that moment. 

I never saw Zack again after that night and don’t know what happened. Wherever he is today, I hope he’s healing and doing well.  

 

Meghan Schilthuis is a third-year medical student at MCW-Milwaukee. She is one of the student leaders of MCW’s MedMoth storytelling event.  

 

There is No Success Alone

From the 1/20/2023 issue of the Transformational Times

There is No Success Alone 

By Cassie Ferguson, MD – Associate Director of the Kern Institute 

 

 

"Talent wins games, but teamwork and intelligence win championships." 

-Michael Jordan 

The depth and breadth of our collective success in the Section of Pediatric Emergency Medicine is staggering. And the pride and reverence with which each of us holds these successes, regardless of the role we played in them, is a testament to the love we have for our patients and for one another.  

It also is a testament to our leader, Dr. David Brousseau.  

Our section begins 2023 with a goodbye to our chief of eleven years, whom we affectionately call D-bro. Dr. Brousseau is leaving for Delaware after 23 years of service to MCW, and I couldn't let him leave without trying my best to explain how much he has meant to me and to all of us – to our team. 

The Section of Pediatric Emergency Medicine is working to address food insecurity among our patient's families, improve patient health literacy and numeracy, strengthen the coordination between the Emergency Department (ED) and our EMS colleagues, decrease sexually transmitted infections in our adolescent patients, share our experience in pediatric sedation medicine with colleagues in under-resourced countries, sharpen our section’s bedside ultrasound skills, ensure all patients have access to life-saving flu vaccines, and give kids who have been victims of interpersonal violence a chance to go to summer camp. Among other things. 

Our team is committed to this challenging work. We also like to win. We are especially proud of wins that showcase our team’s ability to work together creativity – even when it has nothing to do with emergency medicine, and everything to do with teamwork. Even if it’s just for fun. 

For six of the seven years that the Children’s Specialty Group has held a Halloween costume contest at Children’s Wisconsin, the Section of Pediatric Emergency Medicine has either won first place or been in the top three (we don't count the year we were allegedly disqualified). This success is not by accident. Every year, months in advance, we vote on a theme and then each of us—faculty and staff—works on putting together our individual costume such that it fits into the theme. As an often overlooked and perhaps maligned department of the hospital (hey— we don’t like to call you to consult at 0300 either), winning this contest has become a source of pride, primarily because we do it together.  

All hail the Section of Pediatric Emergency Medicine’s Halloween Costume Dynasty. 

“How lucky I am to have something that makes saying goodbye so hard.” 

-A.A. Milne 

I admit this Associate Director's Corner is less an article than a love letter to my pediatric emergency medicine colleagues and to Dr. Brousseau. 

Twelve years ago, I was a new attending physician and had just moved back to Milwaukee with my husband, our three-year old son, and a newborn. I felt so lost. I remember wanting desperately to contribute and to feel useful, yet not knowing how. Within three years, I was co-directing the Quality Improvement and Patient Safety Scholarly Pathway for the medical school, was selected to participate in MCW’s Docere II teaching course and had begun an advanced improvement methods course at Cincinnati Children’s Hospital.  

I acknowledge this required a certain amount of work on my part, but I also know that none of it would have happened without Dr. Brousseau and those foundational opportunities that were key to me building what has become an incredibly fulfilling career. 

Even more meaningfully, for the past 12 years Dr. Brousseau has consistently reminded me what I am capable of and what I contribute, empowering me to take risks and to step into roles I thought were too big for me. 

As I look around at my section colleagues, and at what they have achieved, Dr. Brousseau’s legacy becomes very clear: His leadership has enabled us all to thrive. We are purpose-driven and optimistic; we are continuously learning and pushing for change; we know how we can contribute to the greater good of the section and our community at large and we are given the space to do so. Even in our section's darkest hours, instead of fear and uncertainty and anger tearing us apart, we rose together, becoming closer and more determined to navigate the darkness together. 

"The good leader is he who the people revere. The great leader is he who the people say, we did it ourselves."

-Lao Tzu 

In this country, we like to think of good leadership as big, bold and brash. Crashing through obstacles, pushing past limits. Loudly declaring itself. All-knowing. Strength of conviction is often more apparent than strength of character in the leaders we choose and in those chosen for us. 

Dr. Brousseau, however, has shown me leadership that enables thriving is quiet. It takes mindful, careful steps as if feeling the earth beneath its feet as it walks. This kind of leadership is inclusive. It widens our field of attention and helps us be aware of when we are being called to be more loving, more compassionate, more open hearted. It engenders trust -- not through convincing, but through presence. And it doesn’t get frustrated when it must explain how to calculate positive predictive value for the 1000th time during journal club. 

“Goodbye always makes my throat hurt.” 

-Charlie Brown 

Whenever I sat down with Dr. Brousseau in his office for my annual faculty review, he always began our conversation by asking, "What is your favorite part of your job?"  

If I had that question to answer one more time, knowing that it would be our final faculty review and the last time I would have the chance to share my answer with him, I would say this: 

There are too many favorite parts to name them all. I love showing up to the ED and getting a hug from the person I’m getting sign-out from. I love that when I want to switch a shift so that I can see my kid’s baseball game, someone will instantly volunteer to help. I love that our section meetings never end on time because we are all so excited to see and talk to each other.

Perhaps most of all, I love that I have the freedom to do what I love to do with people I love, and the support and encouragement to keep doing it better.  

Thank you, Dr. Brousseau, for pushing us, for fighting for us, for holding us all together. For helping us to thrive.  

Cassie Ferguson is an Associate Professor in the Department of Pediatrics, Section of Emergency Medicine at MCW. She is the Associate Director of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education.  

Three New Year's Questions for Amy Zosel, MD, MSCS

From the January 20, 2023 New Year’s Resolutions issue of the Transformational Times

Three New Year's Questions for Amy Zosel, MD, MSCS

As part of our January 20, 2023 issue, the newsletter reached out to several facutly, staff, and students and asked them three questions about their hopes and plans for 2023. Here is a resposnse from Emergency Medicine faculty member and recipient of multiple teaching awards, Amy Zosel, MD, MSCS.

Transformational Times: What is one thing that you hope for when you think about 2023? Why? 

Amy Zosel, MD, MSCS: In 2023, I hope for opportunity to reconnect with family and friends. As front-line health care providers, we were asked to ramp up our work, and pour time and energy into solving new problems. There were extra planning meetings and task forces to develop COVID-related clinical pathways and creatively move education to online platforms. While people in other sectors found time to pursue baking sourdough and playing board games, we were busier than normal. Many of us are also trying to figure out how to do online school at home with our kids. As this business dissipates, my hope is to spend more quality time connecting face-to-face with loved ones. I am especially looking forward to travel this year. 

Transformational Times: Do you have a new year's resolution that you can share with us? What inspired you to choose that? How is it going so far? 

Amy Zosel, MD, MSCS: Our Department of Emergency Medicine did an exercise challenge this fall. (Nothing like a little friendly competition to get you on the treadmill). Fitting in a little exercise everyday feels great, so I am aiming to continue that. Thanks, MCW EM Wellness Committee! 

Transformational Times: What do you see as an example of the "new normal" in our world? How do you feel about it? 

Amy Zosel, MD, MSCS: An example of the “new normal” is the opportunity to take meetings via Zoom. While this offers certain flexibility and cuts down on commute time, it can be difficult to engage deeply at home and at work. We need to make sure meetings are meaningful and that we are giving our families the attention they deserve. 

Amy Zosel, MD, MSCS, is an Associate Professor; Interim Division Chief, Medical Toxicology; and Director of Research Operations and Mentorship in the Emergency Medicine Hub for Collaborative Medicine at MCW. She also has been active with the Council for Women’s Advocacy (CWA) -- an advisory committee on issues of professional development of all faculty members.